Losing Doctors!

You sound like a man of action, so this letter is coming to you. If that's not your department, I'm sure you will send it to the right place.

Enclosed is a copy of a letter received from my doctor. He explains why he is leaving his practice. I felt the well-put reasons might be useful when confronting the government.

This is the THIRD doctor we have lost in about the last 12 to 15 years. Kitchener/Waterloo Ontario needs more doctors and specialists. Here's hoping the CSA can do as good a job in this area as they have in others.

We have been members for many years. Whenever I read the CSANews, my admiration soars for all the workers and negotiators.

Thank you for the good work. Being a very private person, I would appreciate remaining anonymous.

The reason for this letter is to further the cause for more good doctors in Ontario and all of Canada.

Letter from Physician
Dear Patients,

I am writing this letter to you to inform you of my decision to leave the practice of family medicine as of February 28, 2005. I announce this with little regret as this decision has been two years in the making. I can no longer practice medicine the way I was taught or would like to without suffering financial hardship. I have searched long and hard for reasons to be optimistic, that the working environment for family physicians in Ontario would improve, and have come up empty. There are many reasons why I am leaving family medicine and I will share some of them with you.

Poor Compensation – The average visit to your family physician pays your doctor only $17.30 - $28.50. A full annual physical earns your doctor $54.10. The fee paid to your doctor for counseling or psychotherapy is $50.45 per half hour of time. Many forms I have to do for free or am paid very poorly as per government regulations. To pay for rent, staffing and supplies costs me over $70 per hour. I do not have any health benefits, paid vacation or pension. What OHIP pays me to look after your medical care does not come close to what I should be receiving given my 11 years of university education, my work responsibilities and workload/complexity.

Government Control – Doctors are not protected by the Labour Relations Act and are not permitted to strike. In addition, we do not have access to binding arbitration in the event of an impasse in negotiations with the government. OHIP rigidly controls how much doctors are paid for their insured services, a situation not encountered by any other independent health care in this province. Dentists and veterinarians charge whatever the market will bear. Even chiropractors, when they were covered by OHIP, were allowed to charge extra fees to their patients.

Lack of time for my family – For most of the last 3 1/2 years I have worked 6 to 7 days per week. I have had one week off in that period and that was the week that my son was born. I spend at least two hours per night on paperwork and, at least twice per week, am up into the morning filling out or writing numerous government, insurance and legal forms and letters. The time that I have devoted to my career has left me worn out and has greatly impacted my role as a father and husband.

Access to Diagnostic Tests – Many times per day I deal with patients who need very quick access to ultrasounds, CT scans, MRIs or other tests in order to make a diagnosis and proceed with proper treatment. These patients often suffer physically, emotionally and financially while their conditions do not improve or continue to worsen. I witness their anguish and sometimes proper treatment is delayed while awaiting necessary tests.

Access to Specialist Care – There is a significant shortage of many specialists in Ontario that is not just limited to our community. This results in long waiting lists for referrals, often after a long wait for a diagnostic test. Even if I have made the diagnosis, often patients require specialist care that I cannot get them timely access to. The result is that I see these frustrated patients back in my office often and can bring little relief to their symptoms.

Family physicians are leaving their practices, retiring or moving out of province in growing numbers. In addition, fewer students are choosing to train as family doctors and those that do are increasingly not setting up family practices. For the last five years, I have been working in a deteriorating system that is not of my making, nor my responsibility. It is not my job to fix the system or subsidize it with my low fees and income.

Response :Thank you for your kudos and your support. It would appear that the health-care crisis in Canada, let alone Ontario, is far from over. Lack of funding and support coupled with the bureaucracy that physicians have to endure in order to get paid is compounded further by the "brain drain" of opportunity just south of our border.

If our government would simply allow doctors to do what they are trained to do, help people and save lives, then perhaps the issue of being under-funded for services would be that much less of a burden on them.

As our population ages the demand for well trained experienced doctors will multiply exponentially. Currently 47% of our Canadian health-care budget is absorbed by persons over the age of 65. As the boomers age we will need more doctors and more funding in order to maintain the Canadian way of life that was envisioned when our national medicare program was created. It is obvious that we are not starting off on the right foot, and action to remedy the problem must be taken now!